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Featured Article: Counting Drinks to Understand Alcohol Use Disorder

November 27, 2018

Alcohol use disorder (AUD) occurs more frequently among young adults than other age groups. Heavy drinking, which is a strong predictor of whether someone will experience an AUD, is common among young adults. The generally accepted guideline for “heavy episodic drinking” or a “binge” is four (for women) or five (for men) or more drinks during a drinking occasion or within a two-hour period. In a forthcoming article by Methodology Center researchers Ashley Linden-Carmichael, Michael Russell, and Stephanie Lanza, the authors used time-varying effect modeling (TVEM) to examine whether these drink thresholds provide the best picture of who is at risk for AUD.

The authors analyzed a sample of more than 6,000 young adult drinkers from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Among other questions, the authors examined whether consuming different average numbers of drinks on each drinking occasion was associated with higher prevalence of AUD. They found that rates of AUD for women increased until women reached about nine drinks per drinking session, when AUD rates plateaued at about 80%. AUD rates plateaued at 80% for men when they consumed about 12 drinks. This study suggests that defining a binge as four or five drinks and focusing prevention messages around that threshold neither matches young adult behavior nor does it enable us to understand the full scope of risky drinking.

Lead author Ashley Linden-Carmichael spoke about the implications of the findings and what further questions remain. “Alcohol clinical trials often use percentage of no-binge-drinking days as a marker of the trial’s efficacy. Our results suggest that focusing on reducing the number of drinks rather than whether they surpassed a threshold may be a better measure of treatment success.” Realistic and useful standards for what constitutes risky drinking could serve as an important tool in the effort to curb young-adult drinking to safer levels.